Lifeworld Existentials Research Articles

Transformative Life Experience as a Glimpse Into Potentiality

Many clients cope with the consequences of transformative life experience (TLE) in psychotherapy. TLE often involves a radical, profound reorganization of or change in one’s life because of resulting formative, life-changing choices. Yet the essence of the mechanism people use to process and make sense of a TLE is unclear. This study is a phenomenological exploration of such experiences that aims to offer a heuristic theoretical view of how such change is constructed and played out. Data were collected through in-depth interviews with 120 adults who had coped with the consequences of a TLE. Data analysis was guided by a hermeneutic phenomenology paradigm that postulates that people account for their experience within the four existentials of temporality, spatiality, corporality (embodiment), and relationality. Those lifeworld existentials were utilized as a framework and lens through which to organize the data. This procedure was followed by a hermeneutical interpretation to identify common features of lived experience along all four domains of analysis with the purpose of constructing a conceptual model that illustrates the essence of change during TLE. Implications are considered for utilizing theoretical and applied insights from the model.

Interreligious learning and teaching: unfolding layers of meaning in lived experience to inform possibilities for students in Catholic schools

This paper explores the question, "What is the individual's experience of interreligious learning and teaching?" It utilises hermeneutic phenomenology to interpret the rich and hidden meanings of lived experiences. van Manen's (Phenomenology of practice: meaning-giving methods in phenomenological research and writing. Routledge, New York, 2014) lifeworld existentials provide a frame for guiding the exploration to uncover insights through lived relation (relationality), lived space (spatiality), lived body (corporeality), lived time (temporality) and lived things (materiality). Current global events have highlighted to the world the tragedy of religious intolerance in extreme forms and the need to cultivate tolerance and sensitivities towards religions and non-religious philosophies and diverse life perspectives. Investigating the phenomena of 'interreligious learning and teaching' as it is lived by individuals, offers insight into what could be one's own or another's lived experience, and how this might influence one's religious identity. Such understandings can provide a foundation for seeking out and engaging students in valuable interreligious learning and teaching experiences and pose opportunities or challenges for primary and secondary school contexts to rigorously grapple with the diverse global reality.

Patients' lived experiences of waiting for and undergoing endovascular aortic repair in a hybrid operating room: A qualitative study.

The overall aim of the study was to illuminate the patients' lived experiences of waiting for and undergoing an endovascular aortic repair (EVAR) in a hybrid operating room (OR). The hybrid OR is an example of the technological advancements within hospitals. The environmental impact on humans is well recognised but is rarely taken into account when hospitals are designed or rebuilt. The patient's experience of a hybrid OR is not earlier described. A qualitative design based on hermeneutic phenomenology was implemented. Interviews were conducted with 18 patients. A thematic interpretation based on van Manen's approach was then used to analyse the findings. The consolidated criteria for reporting qualitative studies (COREQ) were used (Data S1). The following three themes emerged from the interviews: (a) being scheduled for surgery induced both anxiety and hopefulness; (b) feeling watched over and surrendering to others in the technology intense environment and (c) feeling relief but unexpected exhaustion after surgery. In the discussion, the results were additionally reflected upon out from the four lifeworld existentials: lived body, lived space, lived time and lived others. The hybrid OR technology did not frighten the patients, but it was also not an environment that promoted or was conductive to having a dialogue with the staff. The disease and surgery brought feelings of anxiety, which was largely associated with the uncertainty of the situation. We suggest that continuity in contact with staff and patient-centred information could be solutions to further calm the patients. The hybrid OR environment itself did not seem to frighten the patient, but the way the high-tech environment increased the distance between the patient and the multiple staff members needs further investigation.

Life as Experienced Within and Through the Body After the Age of 85 Years: A Metasynthesis of Primary Phenomenological Research.

The body is central to the experience of aging. In this metasynthesis, the authors located, analyzed, and reconceptualized phenomenological research on how life is experienced within and through the body after 85 years. Sandelowski and Barroso's metasynthesis method was employed. Seven databases were searched for primary phenomenological studies. After systematic screening and quality appraisal, 19 studies were included for review. Analysis was guided by Maurice Merleau-Ponty's existential philosophy of embodiment. Findings were organized using Max van Manen's reflective lifeworld existentials. Four ontological dimensions emerged, namely, being in a body (corporeality), being in time (temporality), being in place (spatiality), and being with others (relationality). Each dimension captures a distinct experiential dimension of this stage of the life course. The results suggest vast heterogeneity in the ontological experience of aging, supporting the view that diversity grows with age. The ability to adapt to multidimensional losses was identified as a source of resilience.

The experiences of seven women living with pelvic surgical mesh complications

This research sought to address a gap in the literature about women's lived experience of pelvic surgical mesh complications, conducted by an insider researcher. An increasing number of women who have pelvic mesh surgeries with a view to improving their lives are experiencing life-altering complications. Without knowledge of these experiences we cannot know how best to care for affected women and prevent harm to further women. Van Manen's hermeneutic phenomenological method was used. Seven women with pelvic mesh complications aged 43-69years were enrolled using criterion sampling. Four of the seven women had surgical mesh for both pelvic organ prolapse (POP) and stress urinary incontinence (SUI), one for POP only, and two for SUI only. The women completed a modified ICIQ-LUTSqol questionnaire pre-interview and answered a separate global spiritual question adapted from the HOPE tool, a framework for spiritual assessment. Women were interviewed once using a semi-structured approach. Data were analysed using Van Manen's selective reading technique and organized according to Lifeworld Existentials. Modified ICIQ-LUTSqol scores ranged between 43 and 76 (range 19-76), with a mean of 62.2 (SD + 10.011) demonstrating significant impact on quality of life. Themes emerging from the analysis were: (1) lived space: 1(a) feeling powerless in the medical space, 1(b) living in a shrinking world; (2) lived body: 2(a) living with unrelenting pain, 2(b) inhabiting a body that can no longer be relied on; (3) lived time: 3(a) living in the gap between what was and what could have been; (4) lived other: 4(a) suffering in silence, 4(b) finding absolute Other and others as a source of strength. Pelvic surgical mesh complications have an extensive adverse impact on the lifeworld of women experiencing complications. Failure to acknowledge mesh complications as treatment injury stalls the development of safer alternatives and changes needed to industry practices, regulation, clinical practice, and monitoring to keep women undergoing innovative urogynaecological procedures safe.

Social construction of the experience of living with chronic kidney disease.

ABSTRACTObjective:To understand the experience of people living with Chronic Kidney Disease who have been transplanted, from the meanings constructed based on the experienced phenomenon. Method:Hermeneutic-phenomenological study based on the five lifeworld existentials, according to Van Manen’s theoretical framework. Eleven transplanted patients participated in the study and data collection was carried out through semi-structured interviews, after approval of the study by the Ethics Committee of the University of Antioquia. Results:The theme of Living with Chronic Kidney Disease emerged, and the subthemes were grouped as lifeworld existentials of Temporality: something unexpected, being present and not seeing it, being young and sick. Relationality: support, feeling stuck and Terminal Chronic Renal Failure. Spatiality: changes in life, sadness and depression. Corporeality: body deterioration and changes in sex life. Materiality: effects on the economic status. Conclusions:The care provided to people must be oriented in order to recognize their individualities, understanding what the illness means for the individual and his family, how they live with it and what the changes are, leading them to modify their lives and start a long process, such as living with a chronic disease.

It's a question of endurance – Patients with head and neck cancer experiences of 18 F-FDG PET/CT in a fixation mask

This study aimed to explore how patients with head and neck cancer experienced undergoing an 18F-fluoro-deoxy-glucose positrons emissions tomography/computed tomography (18F-FDG PET/CT) examination in a fixation mask. Interviews were conducted with nine patients with known or suspected head and neck cancer who were scheduled for the examination for the first time. The phenomenological method according to van Manen and his four lifeworld existentials; lived space, lived body, lived time, and lived relation was used to analyse the interviews. The thoughts and feelings of the patients during the PET/CT examination varied, some found it very difficult, while others did not. However, for all the patients, it was an experience that required some form of coping to maintain composure for example distraction. PET/CT examnation in a fixation mask may be strenuous for some patients. Patients need more detailed information, including suggestions for coping behaviours, prior to the examination, as well as higher level of support during and after the examination. The results of this study may be used to improve patient care and optimize the procedure of PET/CT examination in a fixation mask.

Women's experiences of labour and birth when having a termination of pregnancy for fetal abnormality in the second trimester of pregnancy: A qualitative meta-synthesis

Objectiveto explore women's experiences of labour and birth in the context of a termination of pregnancy for fetal abnormality in the second trimester of pregnancy. Designmeta-synthesis of 10 qualitative studies which included the experiences of 581 women. Data analysis was informed by van Manen's four lifeworld existentials (lived body, lived space, lived time and lived human relationships) and focused only on women's experiences of their labour and birth when terminating a pregnancy in the second trimester for fetal abnormality. Key findingseight themes were generated by the analysis. In my head: a storm of emotion reflected the lived or felt space. In this space women make meaning of the experience. Too late to turn back time and Living and escaping the moment considered lived time; it is lived time that enables a woman to reinterpret who they once were and who they are becoming. The existential concept of lived body represented the women's physical or bodily presence and was reflected in the themes; The language of labour: un-describable torture, The meaning of pain; punishment and protection and Being a mother in the space where birth meets death. Relational or the lived human relationship is reflected in See me… talk to me…hear me… be with me and Sorry baby. These themes describe the women's lived sense of others in the interpersonal space that they share with them. Key conclusionsthe findings of this meta-synthesis provide insight into how emotionally and physically traumatic a woman's labour and birth experiences can be in this context. Women wanted to spend time with their baby constructing lasting memories that they could hold onto and share. They needed acknowledgment that their baby existed and their loss was tangible and real. What happened within the space of the relationship women shared with care providers was seen as vital, especially when respectful and dignified interaction was experienced. The women's need for human contact and support through their experience was also seen as critical. Implications for practicethe need for greater understanding and acknowledgement of the woman's experience by all caregivers is required. Woman-centred and situation sensitive care provision should be prioritised. Further research that acknowledges and prioritises the feminine voice and the lived experience of women is required.

Exploring the Meanings of Usage about Onomatopoeia and Mimetic Words in a Child Play Situation

Objective The aim of this study was to examine the meanings of onomatopoeia and mimetic words contextually used contextually when children play together. Methods The participants included 40 children (ages 3–5 years) attending “M Daycare Center” in Seoul and “S Daycare Center” in Seongnam (a city in Gyeonggi-do). Twenty rounds of play observations were conducted at the centers. Once per week from May to October 2015. Results The onomatopoeia and mimetic words observed were primarily relate to physical movements, sounds, and shapes. These types relate to Max van Manen's life-world existentials, correlating with spatiality, corporeality, and relationality. The characteristics of onomatopoeic and mimetic words used were additive and were used by the children to refine and diversify their language skills and enrich their linguistic imaginations. Conclusion Onomatopoeic and mimetic words help children design their own play situations based on their creativity and help them share the play with their peers. Keywords: onomatopoeia, mimetic, play, qualitative research

Beyond the twee: Thuy’s practical expression of living the Mercy Education Value of hospitality

This article utilises hermeneutic phenomenology as a theoretical framework for reflecting upon and interpreting the Mercy Education Value of hospitality. It describes an incident involving the author’s encounter with a member of staff upon his new appointment in a Catholic secondary college formed in the Mercy Tradition. Through this article, the possibilities opened by such an encounter for hermeneutic phenomenology are explored using van Manen’s lifeworld existentials as guides to reflection upon the described incident. The four lifeworld existentials are lived space (spatiality), lived body (corporeality), lived time (temporality) and lived other (relationality). In using these as guides to reflection, it is argued that some insights into the Mercy value of hospitality may be gleaned, namely that to be Mercy involves: (1) exceeding the carefully and socially programmed how are you – fine exchange; (2) an encounter with the other – the stranger – in whom is to be found the person of Jesus Christ, in which both participants are transformed; and (3) taking a risk – pushing boundaries so as to enter into relationship with the other.

A nurse’s phenomenological enquiry into doctors’ end-of-life decision making

This paper is based on an exploratory study conducted in a UK NHS oncology unit, informed by the interpretation of hermeneutic phenomenology by Van Manen and Dahlberg et al. Four senior oncology doctors (trainees) were recruited using homogenous purposive sampling. In-depth interviews were conducted to understand participants’ lived experience of decision making for oncology patients near the end of life. Analysis followed a line-by-line approach, with consideration of the lifeworld existentials identified by ( Van Manen, 1990 ). Common themes were uncovered of empathy, the unacknowledged influence; dichotomy and conflict; and subverted emotion (uncovered through reflection). Findings are discussed in relation to current clinical decision-making theory, particularly cognitive continuum theory, current UK end of life care policy and practice, role socialisation and inter-professional team working.

A Conceptual Model of Spirituality in Music Education

This article aims to describe the phenomenon of spirituality in music education by means of a model derived from the academic literature on the topic. Given the centrality of lived experience within this literature, we adopted a hermeneutic phenomenological theoretical framework to describe the phenomenon. The NCT (noticing, collecting, and thinking) model was used for the qualitative document analysis. Atlas.ti 7, computer-aided qualitative data analysis software, was used to support and organize the inductive qualitative data analysis process. After data saturation, we used Van Manen’s lifeworld existentials (corporeality, relationality, spatiality, and temporality) to help organize the many quotes, codes, and categories that emerged from analyzing the literature. The model that results assigns codes to quotes and codes to categories, which in turn appear within one of these four lifeworlds. This article not only offers a working conceptual model of spirituality in music education but may also help to foster an awareness of spiritual experience in pedagogical contexts and thus contribute to what Van Manen calls “pedagogic thoughtfulness and tact.”

The experience of cognitive change in women with breast cancer following chemotherapy.

Change in cognitive function is one side effect of chemotherapy reported in some breast cancer survivors sometimes years after treatment. These symptoms include subtle changes in memory, concentration, and executive functioning. The purpose of this study was to uncover the meaning of cognitive change in women with breast cancer, how symptoms are experienced and become evident, how symptoms impact roles in personal and professional lives, and how women cope with these changes. An interpretive phenomenological study was conducted with seven women with breast cancer, between the ages of 42-59, who had completed standard chemotherapy treatment within the past 12 months. Participants completed two in-depth semistructured interviews 1 month apart and maintained a written journal. van Manen's framework for interpretive phenomenology revealed five essential themes: noticing the difference, experiencing cognitive changes, interacting socially, coping, and looking forward. Analysis also includes a description of the phenomenon in relation to the lifeworld existentials of lived space, lived body, lived time, and lived human relation. The experience of cognitive change could not be isolated or studied separately from the context of the women's reality of having breast cancer. This study provides clarity related to the impact of cognitive change and how women cope with these changes in relation to their daily roles and responsibilities. Information is provided that elucidates the effect on employment issues that can influence financial and social well-being of women who are breast cancer survivors living with chemotherapy-related cognitive changes.

A room of one's own--Being cared for in a hospital with a single-bed room design.

To illuminate patients' experiences of being hospitalised in a hospital with a single-bed room design. Many patients seem to prefer single-bed hospital rooms. However, studies have also shown that patients do see the advantages of multiple-bed rooms. Interviews were conducted with 16 inpatients from a surgical ward in a hospital building with a single-bed room design. A hermeneutical-phenomenological approach guided by van Manen's four life-world existentials was used to analyse the interviews. The essential meaning was that patients felt secure because they could create a personal environment without disruptive elements. The room was private, and this implied feelings of homeliness, which allowed patients to focus on themselves and was thought to facilitate the recovery process. The patients preferred staying in their room, and the relationship with the personnel was central. Feelings of loneliness and isolation could occur and could be frightening. Being hospitalised in a single-bed room meant balancing between feeling secure and feeling insecure. The following four themes emerged: A homely environment, The need for company and security, Time as unpredictable and involving waiting and Focus on healing the body. Patients experienced that a single-bed room allowed them to focus on their recovery, have visitors without disturbing others and create a feeling of homeliness. However, mobilisation is not a natural part of the recovery process when patients have all they need in their rooms. The patients' need for social interaction and confirmation was not satisfied without effort and planning on the part of staff.

The lived experience of physically active older prostate cancer survivors on androgen deprivation therapy

This study sought to explore the lived experiences of physically active prostate cancer survivors on androgen deprivation therapy (ADT), who exercise individually. Three older men (74–88 years old) with prostate cancer, using ADT continuously for at least 12 months and regularly exercising for at least 6 months, participated in this qualitative pilot study, informed by interpretive phenomenology. Data were gathered using individual semi-structured interviews, audio recorded and transcribed verbatim. Coherent stories were drawn from each transcript and analyzed using iterative and interpretive methods. van Manen’s lifeworld existentials provided a framework for interpreting across the research text. Three notions emerged: Getting started, Having a routine and Being with music. Together they reveal what drew the participants to exercising regularly despite the challenges associated with their cancer and treatments. This study provides insights into the benefits of, and what it means for, older men with prostate cancer to regularly exercise individually. These findings may assist cancer clinicians and other allied health professionals to be more attuned to prostate cancer survivors’ lived experiences when undergoing ADT, allowing clinicians to better promote regular exercise to their patients as a foundational component of living well.

Mentoring student nurses and the educational use of self: A hermeneutic phenomenological study

In the United Kingdom, pre-registration nurse education relies on workplace mentors to support and assess practice learning. Despite research to clarify expectations and develop support structures, mentors nevertheless report being overwhelmed by the responsibility of mentoring alongside their clinical work. Understanding of their lived experience appears limited. The aim of the study was to achieve a deeper understanding of the lived experience of mentoring, searching for insights into how mentors can be better prepared and supported. The mentor lifeworld was explored utilizing a hermeneutic phenomenological methodology drawing on Heidegger. Twelve mentors, who worked in a range of clinical settings in England were recruited via purposive and snowball sampling. Participants described their experiences of mentoring through in-depth interviews and event diaries which included 'rich pictures'. Analysis involved the application of four lifeworld existentials proposed by van Manen - temporality, spatiality, corporeality and relationality. The essence of being a mentor was 'the educational use of self'. Temporality featured in the past self and moving with daily/work rhythms. Spatiality evoked issues of proximity and accountability and the inner and outer spaces of patients' bodies. Mentor corporeality revealed using the body for teaching, and mentors revealed their relationality in providing a 'good educational experience' and sustaining their 'educational selves'. 'The educational use of self' offers insight into the lived experience of mentors, and exposes the potentially hidden elements of mentoring experience, which can inform mentor preparation and support.

Navigating the Terrain of Lived Experience: The Value of Lifeworld Existentials for Reflective Analysis

In qualitative research we are often presented with a tension between having open and fluid interviews to support staying true to the lived experiences of participants and achieving a level of abstraction from the data in order to uncover the essential structures and meanings of that particular lived experience. A way of resolving this tension is through the application of theoretical frameworks. Van Manen's four lifeworld existentials offer a lens through which to explore and navigate disparate interview data and uncover the essences of lived experience, without imposing categories upon the data itself. Drawing on a study exploring the lived experiences of childless women, we explore the process and principles in operationalising the existentials and discuss the potential implications for analysis and findings. The article demonstrates how Van Manen's lifeworld existentials present us with a holistic and valuable method for reflective practice, in coming to understand lived experience.

Antidepressant Use Amongst College Students: Findings of a Phenomenological Study

Background: Depression among college students is an escalating problem and could have serious consequences such as suicide. There has been an increase in use of antidepressants on college campuses in United States. However, an in depth understanding of this phenomenon from the college student's perspective is lacking in the literature.
 Objective: This study examined college students' experiences and treatment decision making during their depression treatment.
 Methods: A longitudinal, phenomenological research methodology was completed. The participants were nine students who were taking antidepressants for diagnosis of depression. Recruitment was done via brochures placed at University bulletin boards, and a mental health clinic. Three audio taped, unstructured interviews were conducted with each participant over four months. The central question asked was: What has the experience of treating depression been for you? Analysis of text was done using Van Manen's lifeworld existentials of lived body, lived time, lived relation and lived space as the organizing framework.
 Results: Thirteen themes were identified within the four lifeworlds. The results showed that lived relation with providers was important for college students' decision to both initiate and continue antidepressant use. Students' role was defined in conjunction with provider's role by them as wanting to be a 'player' in their treatment decisions and needing to be 'acknowledged' as such by their providers.
 Conclusions: Overall, the underlying essential theme of ‘autonomy’ was portrayed by the students’ experiential accounts of their depression treatment and treatment decision making.
 
 Type: Original Research

Medication Experiences of Hispanic People Living with HIV/AIDS

Objective: The objective of this study was to describe the medication experiences of Hispanic people living with HIV/AIDS. Specific aims were to describe their current medication experiences and to describe how they viewed their medication history in order to determine essential themes for improving culturally-appropriate medication therapy management services.
 Methods: A qualitative, phenomenological research methodology was employed. Ten adults living with HIV/AIDS were audiotaped during semi-structured, in-depth interviews conducted in Spanish. In addition to audiotaping, field notes were taken. Thematic analysis of text was done to obtain themes consistent with the research objectives. Analysis was accomplished in two phases. The first phase applied Van Manen's lifeworld existentials of lived body, lived time, lived relation and lived space as the organizing framework for identifying themes. The second phase identified "essential themes" using holistic, selective, and detailed approaches that were applied to the themes identified in the first phase.
 Results: The results showed that lifeworld existentials were relevant medication experiences for Hispanic patients living with HIV/AIDS and their medication-taking behavior during their lives. Ten themes were identified. From these, we identified an overall "essential theme" comprised of: (1) Duality of Living with HIV/AIDS and (2) Primacy of Medications for Hispanic HIV/AIDS patients.
 Conclusions: The findings revealed that the medication taking experiences for Hispanic people living with HIV/AIDS can be described in terms of the duality of living with HIV/AIDS as "living dead" patients and in terms of the centrality that medications take in their lives, even to the point of a spiritual level.
 Type: Original Research

Women’s stories of their experiences as overweight patients

This paper is a report of a study to illuminate the meaning of women's experiences as overweight patients in their encounters with healthcare services and healthcare providers. Overweight and obesity are increasingly important issues for women's health internationally. Overweight or obese women may delay or avoid health care if care providers have previously reacted negatively to them based on weight. However, studies focusing on the meaning of women's experiences as overweight patients and as recipients of healthcare services are lacking. A hermeneutic phenomenological approach was used. Face-to-face interviews were conducted in the United States of America in 2007 with eight women volunteers who self-identified as being overweight patients. The framework of van Manen's lifeworld existentials of lived space, lived body, lived time and lived relation-guided reflection for data analysis. The essence of women's experiences was a battle to fit into the world of healthcare services. Four major themes were identified. 'Struggling to fit in' consisted of trying to fit into limited physical space (examination rooms, equipment), limited time, and limited satisfaction and support in relationships with healthcare providers. 'Being dismissed' consisted of demeaning and embarrassing interactions with providers. 'Feeling not quite human' involved the stigma of being different because of body size. 'Refusing to give up' consisted of persistence in seeking support and advice from professionals despite negative past experiences. Awareness of these findings could reform understanding of women's experiences as overweight patients and raise the consciousness of nurses worldwide to develop sensitive communication strategies and healthcare environments that support holistic care.